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Mass testing plan to tackle AIDS

A radical new strategy to stop the Aids epidemic in its tracks was proposed on Tuesday by World Health Organisation scientists but ran into immediate controversy over its implications for human rights.

The plan involves testing everybody for HIV every year in hard-hit areas like sub-Saharan Africa and immediately putting those who are positive on AIDS drugs. It could slash dramatically the number of new infections, because AIDS drugs lower the levels of virus in the body, making HIV transmission through unprotected sex much less likely.

But the strategy, expounded in a paper published online today by the Lancet medical journal, raises major issues both over implementation and over ethics.

Currently people who are HIV positive are not put on treatment until they need it, because of the toxicity and side-effects of antiretroviral drugs. It raises the prospect of subjecting people to potential medical harm for the public good, rather than their individual benefit. “We wouldn’t do that in the U.K.,” said John Howson of the International HIV/AIDS Alliance. “These are huge issues.”

The authors of the paper include Kevin de Cock, HIV/AIDS director at the WHO, who points out that this is a mathematical model for discussion, but says it offers hope at a time when other avenues appear to have closed. If this could be implemented in sub-Saharan Africa, he told the Guardian in an interview, “the proportion of people with HIV would run to under 1 per cent in less than 50 years.”

Prospects for a vaccine against HIV infection have slumped after a number of failures, particularly the halting last year of a trial by the pharmaceutical company Merck around which there had been great optimism.

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